小儿疳病肿胀之证,气逆喘咳,胸膈痞闷,肚腹肿胀,面色浮光,多因传化失宜,脾肺两伤所致,古法主御
苑匀气散(如桑皮、桔梗、赤苓、甘草、藿香、陈皮、木通,引用姜皮、灯芯)。
〔真按〕疳者干也,灼津液而干于内者多,窒枢机而肿于外者少,此证宜平其乖逆之气,复其传化之权,
方用炒枳实一钱,制野术钱半,蜜炙桑皮钱半,广木香五分,姜制竹茹钱半,大腹皮六分,茯苓皮三钱,小青皮
三分,留白陈皮五分,方通草五分,引用丝瓜络三寸。
小儿疳痢,皆由热结肠胃,证见腹中窘痛,下痢或赤或白,古法主香连导滞汤(如青皮、陈皮、浓朴、川芎、
川黄连、生甘草、山楂、神曲、木香、槟榔、大黄,引用灯芯)。
〔真按〕痢系疳疾曰久,而下赤白,小儿之肠胃,因疳积热,因热下痢,且因胃热而牵及肠热,法宜双清
肠胃,其积热始得下行,方用生锦纹五分,人中黄一钱,油浓朴八分,川黄连三分,生条芩八分,煨木香一钱,
结槟榔八分,广橘红钱半,建神曲钱半,最好以雪水煎药服,无雪水改用长流水亦可。
小儿肝疳,证见面目爪甲皆青,眼生眵泪,隐涩难睁,摇头揉目,合面睡卧,耳疮流脓,腹大青筋,身体羸
瘦,燥渴烦急,粪青如苔诸状,古法主柴胡清肝散(如银柴胡、炒栀子、连翘、
生地、黄连、赤芍、龙胆草、青皮、生甘草,引用灯芯、竹叶)。
〔真按〕肝属木,色青主筋,故病状多现青色,以柴胡舒肝,须防迫火上炎,以龙胆泻肝,亦虑伤阴下降,
法宜凉肝平木,则热自清,方用细生地二钱,生白芍钱半,赤芍药一钱,人中白八分,霍山石斛钱半,云茯苓二
钱,胡黄连五分,淡竹叶钱半,五谷虫钱半,引用鲜车前草一钱,鲜茅根二钱。
小儿疳病出现肿胀的证候,表现为气逆喘咳、胸膈痞闷、肚腹肿胀、面色浮肿有光泽。这多因脾胃传化功能失调,导致脾肺两脏受损所致。古法主张使用御苑匀气散(包含桑白皮、桔梗、赤茯苓、甘草、藿香、陈皮、木通,煎药时加入姜皮和灯芯草作为引子)。
〔陈守真按语〕“疳”字意为干枯,体内津液被灼烧而致干枯的情况较多,因气机阻滞而导致体表肿胀的情况较少。此证应当平复其乖戾逆乱之气,恢复其脾胃传化的职权。方剂选用炒枳实一钱,制苍术钱半,蜜炙桑白皮钱半,广木香五分,姜制竹茹钱半,大腹皮六分,茯苓皮三钱,小青皮三分,留白陈皮五分,川通草五分,以丝瓜络三寸为引子。
小儿患疳痢,皆由热邪结聚于肠胃所致。症状表现为腹部拘急疼痛,下痢或带血或带脓白。古法主张使用香连导滞汤(包含青皮、陈皮、厚朴、川芎、川黄连、生甘草、山楂、神曲、木香、槟榔、大黄,以灯芯草为引子)。
〔陈守真按语〕痢疾是疳疾日久发展而来,且排泄物中夹杂红白脓血。小儿的肠胃因疳积蕴热,因热而下痢,且因胃热牵连导致肠热。治法宜双清肠胃之热,使积热得以下行。方剂选用生锦纹(大黄)五分,人中黄一钱,油厚朴八分,川黄连三分,生黄芩八分,煨木香一钱,结槟榔八分,广橘红钱半,建神曲钱半。最好用雪水煎药服用,若无雪水,改用长流水也可以。
小儿患肝疳,症状表现为面目及爪甲均呈青色,眼部分泌物多且流泪,眼睛干涩难以睁开,摇头揉眼,趴着睡觉,耳疮流脓,腹部胀大且有青筋暴露,身体消瘦,口干烦躁急切,粪便颜色青绿如苔藓等状况。古法主张使用柴胡清肝散(包含银柴胡、炒栀子、连翘、生地、黄连、赤芍、龙胆草、青皮、生甘草,以灯芯草和竹叶为引子)。
〔陈守真按语〕肝属木,色青主筋,因此病症多现青色。使用柴胡疏肝时,须防止火势迫上炎升;使用龙胆草泻肝时,亦需顾虑损伤阴液并导致气机下降。治法宜凉肝平木,则热邪自然清除。方剂选用细生地二钱,生白芍钱半,赤芍药一钱,人中白八分,霍山石斛钱半,云茯苓二钱,胡黄连五分,淡竹叶钱半,五谷虫钱半,以鲜车前草一钱、鲜茅根二钱为引子。
The syndrome of edema in pediatric malnutrition (Gan disease) is characterized by rebellious Qi causing wheezing and cough, chest and diaphragm fullness and oppression, abdominal distension and swelling, and a puffy luster to the facial complexion. This is mostly caused by dysfunction of transportation and transformation, resulting in damage to both the Spleen and Lung. The ancient method advocates using Yuyuan Yunqi San (Imperial Garden Harmonizing Qi Powder), which includes Sangbai Pi (Morus Albae Cortex), Jiegeng (Platycodonis Radix), Chiling (Poria Cocos with Red Core), Gancao (Glycyrrhizae Radix et Rhizoma), Huoxiang (Agastachis Herba), Chenpi (Citri Reticulatae Pericarpium), Mutong (Akebiae Caulis), with Jiangpi (Zingiberis Pericarpium) and Dengxincao (Typhae Stamen) as guides for decoction.
[Chen Shouzhen’s Note:] "Gan" implies dryness; cases where internal fluids are scorched leading to dryness are common, whereas cases where swelling occurs externally due to obstruction of pivot mechanisms are rare. For this syndrome, it is appropriate to calm the rebellious and chaotic Qi and restore the authority of transportation and transformation. The prescription consists of Chao Zhishi (Fried Aurantii Fructus) 1 qian, Zhi Yuzhu (Processed Atractylodis Macrocephalae Rhizoma) 1.5 qian, Mi Zhi Sangbai Pi (Honey-fried Morus Albae Cortex) 1.5 qian, Guang Muxiang (Vladimiriae Root) 0.5 qian, Jiang Zhi Zhuru (Ginger-processed Bambusae Medulla) 1.5 qian, Dafupi (Arecae Pericarpium) 0.6 qian, Fulingpi (Poria Cocos with Brown Skin) 3 qian, Xiao Qingpi (Immature Citrus Peel) 0.3 qian, Liu Bai Chenpi (Tangerine Peel retaining white pith) 0.5 qian, Tongcao (Tetrapanacis Medulla) 0.5 qian, with Sigualuo (Luffae Fibra) 3 cun as a guide.
Pediatric Gan dysentery arises from heat accumulation binding in the intestines and stomach. Symptoms include cramping abdominal pain, and dysentery with discharge that is either bloody or purulent-white. The ancient method advocates using Xianglian Daozhi Tang (Costus and Coptis Decoction for Guiding Out Stagnation), which includes Qingpi (Immature Bitter Orange Peel), Chenpi (Tangerine Peel), Houpo (Magnoliae Officinalis Bark), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chuan Huanglian (Coptidis Rhizoma), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Shanzha (Crataegi Fructus), Shenqu (Medicated Leaven), Muxiang (Vladimiriae Root), Binglang (Areca Seed), Dahuang (Rhei Radix et Rhizoma), with Dengxincao (Typhae Stamen) as a guide.
[Chen Shouzhen’s Note:] Dysentery is a prolonged stage of Gan disease, characterized by red and white discharge. In children, the intestines and stomach suffer from heat generated by Gan accumulation; this heat causes dysentery, and gastric heat extends to intestinal heat. The treatment principle should be to clear both the stomach and intestines simultaneously, allowing the accumulated heat to descend. The prescription uses Sheng Jinwen (Raw Rhubarb/Dahuang) 0.5 qian, Renzhonghuang (Human Excrement Yellow) 1 qian, You Houpo (Oil-treated Magnoliae Officinalis Bark) 0.8 qian, Chuan Huanglian (Coptidis Rhizoma) 0.3 qian, Sheng Tiaohuangqin (Raw Scutellariae Radix) 0.8 qian, Wei Muxiang (Roasted Vladimiriae Root) 1 qian, Jie Binglang (Knot Areca Seed) 0.8 qian, Guang Juhong (Broad Tangerine Pulp) 1.5 qian, Jian Shenqu (Jian Medicated Leaven) 1.5 qian. It is best to decoct the medicine with snow water; if unavailable, flowing river water may be used as a substitute.
Pediatric Liver Gan presents with cyanosis of the face, eyes, and nails, excessive eye discharge and tearing, dryness and difficulty opening the eyes, head shaking and eye rubbing, sleeping face-down, otitis externa with pus discharge, abdominal distension with visible subcutaneous veins, emaciation of the body, dry mouth with irritability and urgency, and green stools resembling moss. The ancient method advocates using Chaihu Qinggan San (Bupleurum Clearing Liver Powder), which includes Yin Chaihu (Stellariae Radix), Chao Zhizi (Fried Gardenia Fruit), Lianqiao (Forsythiae Fructus), Sheng Di (Rehmanniae Radix), Huanglian (Coptidis Rhizoma), Chi Shao (Paeoniae Radix Rubra), Longdan Cao (Gentianae Radix), Qingpi (Immature Bitter Orange Peel), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), with Dengxincao (Typhae Stamen) and Zhuye (Bamboo Leaf) as guides.
[Chen Shouzhen’s Note:] The Liver belongs to Wood, its color is green, and it governs the sinews; therefore, pathological signs often manifest as cyanosis. When using Chaihu (Bupleuri Radix) to soothe the Liver, one must guard against forcing fire to flare upward; when using Longdan Cao (Gentianae Radix) to drain Liver heat, one must also worry about damaging Yin and causing downward collapse. The treatment principle should be to cool the Liver and pacify Wood, so that heat clears naturally. The prescription consists of Xi Shengdi (Fine Rehmanniae Radix) 2 qian, Sheng Baishao (Raw Paeoniae Radix Alba) 1.5 qian, Chi Shaoyao (Red Paeonia Root) 1 qian, Renzhongbai (Calculus Humanus) 0.8 qian, Huoshan Shihu (Huoshan Dendrobii Caulis) 1.5 qian, Yun Fuling (Yunnan Poria Cocos) 2 qian, Hu Huanglian (Coptidis Rhizoma var. chinensis) 0.5 qian, Dan Zhuye (Light Bamboo Leaf) 1.5 qian, Wugu Chong (Insect Larvae) 1.5 qian, with Xian Cheqiancao (Fresh Plantaginis Herba) 1 qian and Xian Maogen (Fresh Imperatae Rhizoma) 2 qian as guides.